| Beyond Dynamic Potential LLC | |
|
15230 Regina Dr Brandywine MD 20613-4225 | |
| (240) 844-2441 | |
| Not Available |
| Full Name | Beyond Dynamic Potential LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 15230 Regina Dr, Brandywine, Maryland |
| Authorized Official Name and Position | Stephanie M Brown-gilbert (OWNER) |
| Authorized Official Contact | 2408442441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beyond Dynamic Potential LLC 15230 Regina Dr Brandywine MD 20613-4225 Ph: (240) 844-2441 | Beyond Dynamic Potential LLC 15230 Regina Dr Brandywine MD 20613-4225 Ph: (240) 844-2441 |
| NPI Number | 1184365462 |
|---|---|
| Provider Enumeration Date | 04/02/2022 |
| Last Update Date | 04/02/2022 |
| Certification Date | 04/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184365462 | NPI | - | NPPES |
| 212130100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (NU) | Secondary |
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 104100000X | Social Worker | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
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